The purpose of this research is to compare the efficacy of PESSI (Patient Evaluation System of Sequential Instruction) versus regular i=or usual instruction in promoting role and physiological adaptation in post myocardial women patients. Adaptation is defined according to the Roy model of nursing. The specific aim of the study is: the PESSI instructional protocol will be more effective than regular patient teaching protocol in facilitating adaptation in post myocardial women related to 1) role function: being female, family member, homemaker, paid worker, marital-sexual partner, and church member; and 2) physiological function: pain-comfort management, fatigue-energy level, exercise-rest-sleep activity, and risk protection activity. The hypotheses to be tested in this randomized controlled experimental two group design are: 1) role functioning scores of coronary women who have received the PESSI instructional nursing protocol will show higher adaptation over time than coronary women who have received the regular instructions as measured by the Perceived Role Adjustment Scale; Family Responsibility Index; Olson's Adaptation- Cohesion Scale; and Perceived Sexual Adjustment Scale; 2) physiological health scores of coronary women who have received the PESSI instructional nursing protocol will show higher adaptation over time than coronary women who have received the regular instructions as measured by the Sickness Impact Scale, Psychological General Well-Being Index, and Perceived Health Assessment and Risk Protection Survey; Piper Fatigue Scale, Multidimensional Pain Inventory, Self Care and Leisure Time Activity Scale; 3) physiological functioning of coronary women who have received the PESSI instructions nursing protocol will show increased adaptation over time as measured by apical heart rate; arterial blood pressure; weight percentage of body fat; journal record of performance of standardized walking exercise as measured by rate of perceived exertion; record of rest periods and hours of sleep. The sample will consist of women ages 38 or older who have experienced an initial myocardial infarction; be 190 in number: 95 in treatment group; 95 in the control group; be from urban, suburban, and rural areas. Data analysis will consist of 1) descriptive statistics to measure demographic, pre-intervention, and outcome data; and 2) inferential statistics based on 2x4 repeated measures MANOVA design comparing two experimental groups over time with outcomes measured at baseline; 6 months; 12 months; and 18 months post enrollment. The outcome of this research will be an evaluation of the patient's adaptive response to post coronary long term instruction that they themselves will have identified as needed, presented in the mode and sequence of their learning style.